噪音作業勞工聽力損失研究

Surveillance on Noise-Induced Hearing Loss in Taiwan

噪音性聽力損失是盛行率極高的職業病之一，而且一旦發生聽力損失是無法恢復或治癒的；若事先能進行防範措施，噪音性聽力損失是可以有效預防的。本研究利用臺灣地區「噪音作業勞工聽力閾值監視系統」資料庫進行統計分析，以瞭解噪音作業勞工的聽力損失情形及聽力損失特性，並分析聽力損失異常危險因子，以做為施政方針之參考依據。本研究重要結果如下：劣耳各頻率的平均聽力閾值介於 20.9-28.1dB 之間。2k至 8kHz 範圍內，聽力閾值隨著頻率增高而增加，聽力閾值最大的頻率落於 6kHz 處。勞工有中度或中度以上聽力損失者占 9.7%中。聽力損失異常危險因子分析結果顯示，聽力損失異常影響程度最大的危險因子為年齡，其餘由大至小依次為行業、性別、醫院級別、測定場所及入廠年數。年齡（以 10 歲為間隔）的異常危險比為 2.6。危險比最大的三行業為橡膠製品製造業（7.2）、個人服務業（4.2）、運輸工具製造修配業（3.3）。男性／女性危險比 3.0。各聽力檢查施測場所（醫院、工廠、健檢巡迴車）之檢出異常比，以醫院檢出異常比最高。入廠年數（以 5 年為間隔）的異常危險比為 1.08。針對研究結果建議宜進行噪音改善計畫，並加強實施勞工聽力保護計畫。尤其橡膠製品製造業，個人服務業，運輸工具製造修配業，及非金屬礦物製品製造業應列為優先改善的行業。同時宜針對聽力檢查過程及品質進行管理、評鑑及研究，尤其工廠或巡迴健檢車施測品質應加強管控。

Noise-induced hearing loss is a high-prevalence occupational disease. It is irreversible, but can be prevented effectively. This paper used the database from ’Surveillance of Noise-Induced Hearing Loss in Taiwan’. The objectives are:　1) to recognize the extent of noise-induced hearing loss and hearing loss characteristics, 2) to analyze the risk factors of hearing abnormality, 3) to help the competent authority making policy and revising regulation . Important results are as following: 1. The mean hearing threshold of worse ear in the range from 250Hz to 8kHz were between 20.9 and 28.1dB. The mean hearing threshold increased with frequency from 2k through 8kHz. The greatest hearing threshold was at 6kHz. 2. There were 9.7% labors who suffer at least moderate degree of noise-induced hearing loss. 3. Analyze risk factors of hearing abnormality with logistic regression. The risk factors were age, industry, sex, hospital grade, measuring site, and working years at the current industry. The odds ratio of age (age category was 10 years interval) was 2.6. The first three industries with highest OR were rubber manufacture industry (odds ratio=7.2), personal service business (odds ratio=4.2), and transportation equipment manufacture industry (odds ratio=3.3). Men were threefold as likely to suffer hearing abnormality than women. The abnormal rates varied with measuring site. Hearing abnormal rates measured in hospitals were 2.14 fold higher than that in the factories. The odds ratio of working years at current industry (year category was 5 years interval) was 1.08.